Prevalence and factors associated with malnutrition among head and neck cancer patients at the Uganda Cancer Institute Mulago

Abstract

Background: Undernutrition is a major source of morbidity and mortality in cancer patients. These patients are susceptible to nutritional depletion due to the physical and metabolic effects of cancer, as well as anticancer therapies. Malnutrition has been known to be associated with poor prognosis in cancer patients and its presence can limit patient response to anti-cancer treatment therapies (chemotherapy, chemo-radiation, surgery). However, there is limited data regarding the magnitude and predictors of malnutrition among patients with HNC in Uganda.Objective: To assess the prevalence of malnutrition and the contributing factors among HNC patients at Uganda Cancer Institute, Mulago. Methodology: A cross-sectional study was conducted at the Uganda Cancer Institute during the HNTB over a period of 6 months. Consecutive sampling was employed where all new patients with HNC were enrolled as they arrived at the HNC tumor board. 154 patients above 18 years who had a histological diagnosis of HNC and provided informed consent were selected and recruited into the study. Structured questionnaires were administered and Anthropometry measurements were taken and recorded in the structured questionnaires. Results: 154 HNC patients with a median age of 50 years were recruited in our study. The sex distribution showed a male predominance of 63%. Most participants had oral cavity tumours (29.9%). The prevalence of malnutrition was 32.5% using a BMI of <18.5kg/m2 and 39.6% using Serum Albumin <35g/l. Stage IV disease was the most significant factor affecting the nutritional status of HNC patients P=0.002 with serum albumin as the assessment method and a P=0.03 with BMI as the assessment tool. Conclusion: Using both methods, the prevalence of malnutrition was high with each assessment tool though higher with albumin than BMI. The tumour stage emerged as the most significant factor. It is important to identify and address factors that contribute to malnutrition in HNC patients to reduce morbidity and mortality.